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81 Cards in this Set
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- Back
- 3rd side (hint)
Fluid Volume Deficit
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- thready, increased pulse rate, decreased BP and orthostatic hypotension
- flat neck and hand veins in dependent positions, diminished peripheral pulses, decreased CVP, dysrhythmias - increased rate and depth of respirations, dyspnea (labored breathing) - decreased CNS activity (from lethargy to coma), fever (fluid loss dependent), skeletal muscle weakness, decreased urine output - dry skin, poor turgour, tenting, dry mouth - decreased motility and diminished bowel sounds, constipation, thirst, decreased body weight |
LABORATORY FINDINGS:
- increased serum osmolality - increased hematocrit - increased BUN levels - increased sodium levels - increased urine specific gravity |
|
Fluid Volume Excess
|
- bounding, increased pulse rate, elevated BP, distended neck and hand veins, elevated CVP, dysrhythmias
- increased (shallow) respiratory rate, dyspnea (labored breathing), moist crackles on auscultation - altered LOC, headache, visual disturbances, skeletal muscle weakness, parasthesias (prickling, tingling, numbness) - increased urine output (if kidneys can compensate), decreased urine output (if kidney damage is the cause) - pitting edema (dependent areas), pale and cool skin - increased motility in GI tract, diarrhea, increased body weight, liver enlargement, ascites (fluid in peritoneal cavity - abdominal swelling) |
LABORATORY FINDINGS:
- decreased serum osmolality - decreased hematocrit - decreased BUN level - decreased sodium levels - decreased urine specific gravity |
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Isotonic Overhydration
|
- inadequately controlled IV therapy
- renal failure - long-term corticosteroid therapy |
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Hypertonic Overhydration
|
- excessive sodium ingestion
- rapid infusion of hypertonic saline - excessive sodium bicarbonate therapy |
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Hypotonic Overhydration
|
- early renal failure
- congestive heart failure - syndrome of inappropriate ADH secretion - inadequately controlled IV therapy - replacement of isotonic fluid loss with hypotonic fluids - irrigation of wounds and body cavities with hypotonic fluids |
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Serum Calcium
|
8.6 - 10.0 mg/dL
|
COMMON FOOD SOURCES
- cheese, collard greens, milk and soy milk, rhubarb, sardines, spinach, tofu, yogurt |
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Hypocalcemia
|
INHIBITION OF CALCIUM ABSORPTION FROM THE GI TRACT
- inadequate oral intake of calcium - lactose intolerance - malabsorption syndromes such as celiac sprue or Crohn's disease - inadequate intake of Vitamin D - end-stage renal disease INCREASED CALCIUM EXCRETION - renal failure, polyuric phase - diarrhea - steatorrhea (presence of excess fat in feces) - wound drainage (especially GI) CONDITIONS THAT DECREASE THE IONIZED FRACTION OF CALCIUM - hyperproteinemia - alkalosis - medications such as calcium chelators or binders - acute pancreatitis - hyperphosphatemia - immobility - removal or destruction of the parathyroid glands |
CARDIOVASCULAR:
- decreased heart rate; hypotension; diminished peripheral pulses RESPIRATORY: - not directly affected; however, respiratory failure or arrest can result from decreased respiratory movement because of muscle tetany (intermittent muscular spasms) or seizures NEUROMUSCULAR: - irritable skeletal muscles: twitches, cramps, tetany, seizures - painful muscle spasms in the calf or foot during periods of inactivity - positive Trousseau's (carpal spasm) and Chvostek's (contraction of facial muscles) signs - hyperactive deep tendon reflexes; anxiety; irritability RENAL: - urinary output varies depending on the cause GI: - increased gastric motility; hyperactive bowel sounds; cramping; diarrhea LABS: - serum calcium level <8.6 mg/dL ECG CHANGES: - Prolonged ST Interval - Prolonged QT Interval |
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Hypercalcemia
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INCREASED CALCIUM ABSORPTION
- excessive oral intake of calcium - excessive oral intake of Vitamin D DECREASED CALCIUM EXCRETION - renal failure - use of thiazide diuretics INCREASED BONE REABSORPTION OF CALCIUM - hyperparathyroidism - hyperthyroidism - malignancy (bone desctruction from metastatic tumors) - immobility - use of glucorticoids HEMOCONCENTRATION - dehydration - use of lithium - adrenal insufficiency |
CARDIOVASCULAR:
- increased HR in the early phase; bradycardia that can lead to cardiac arrest in the late phase - increased BP; bounding, full peripheral pulses RESPIRATORY: - ineffective respiratory movement as a result of profound skeletal muscle weakness NEUROMUSCULAR: - profound muscle weakness; diminished or absent deep tendon reflexes; disorientation; lethargy; coma RENAL: - urinary output varies depending on the cause - formation of renal calculi; flank pain GI: - decreased motility and hypoactive bowel sounds; anorexia; nausea; abdominal distention; constipation LABS: - serum calcium level >10 mg/dL ECG CHANGES: - Shortened ST segment - Widened T Wave |
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Serum Magnesium
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1.6 - 2.6 mg/dL
|
COMMON FOOD SOURCES:
- avocado, canned white tuna, cauliflower, green leafy vegetables (spinach, broccoli), milk, oatmeal, peanut butter, peas, pork, beef, chicken, potatoes, raisins, yogurt |
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Hypomagnesemia
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INSUFFICIENT MAGNESIUM INTAKE
- malnutrition and starvation - vomitting or diarrhea - malabsorption syndrome - Celiac disease - Crohn's disease INCREASED MAGNESIUM SECRETION - medications such as diuretics - chronic alcoholism INTRACELLULAR MOVEMENT OF MAGNESIUM - hyperglycemia - insulin administration - sepsis |
CARDIOVASCULAR:
- tachycardia; hypertension RESPIRATORY: - shallow respirations NEUROMUSCULAR: - twitches; parasthesias; positive Trousseau's and Chvostek's signs; hyperreflexia; tetany; seizures CNS: - irritability; confusion LABS: - serum magnesium levels <1.6 mg/dL ECG CHANGES: - Tall T Waves - Depressed ST Segment |
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Hypermagnesemia
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INCREASED MAGNESIUM INTAKE
- magnesium-containing antacids and laxatives - excessive administration of magnesium via IV DECREASED RENAL EXCRETION OF MAGNESIUM AS A RESULT OF RENAL INSUFFICIENCY ** CALCIUM GLUCONATE IS THE ANTIDOTE FOR MAGNESIUM OVERDOSE** |
CARDIOVASCULAR:
- bradycardia; dysrhythmias; hypotension RESPIRATORY: - respiratory insufficiency when the skeletal muscles of respiration are involved NEUROMUSCULAR: - diminished or absent deep tendon reflexes; skeletal muscle weakness CNS: - drowsiness and lethargy that progresses to coma LABS: - serum magnesium levels >2.6 mg/dL ECG CHANGES: - Prolonged PR Interval - Widened QRS Complexes |
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Serum Potassium
|
3.5 to 5.1 mEq/L
*used to evaluate cardiac, renal, GI functions and the need for IV replacement therapy* *clients with elevated WBC and platelet counts may have falsely elevated potassium levels* |
COMMON FOOD SOURCES:
- avocado, bananas, cantaloupe, carrots, fish, mushrooms, oranges, potatoes, pork, beef, veal, raisins, spinach, strawberries, tomatoes |
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Hypokalemia
|
ACTUAL TOTAL BODY POTASSIUM LOSS
- excessive use of medications such as diuretics or corticosteroids - increased secretion of aldosterone (Cushing's syndrome) - vomitting, diarrhea - wound drainage (particularly GI) - prolonged NG suctioning - excessive diaphoresis - renal disease impairing reabsorption of potassium INADEQUATE POTASSIUM INTAKE - NPO MOVEMENT OF POTASSIUM FROM THE EXTRACELLULAR FLUID TO THE INTRACELLULAR FLUID - alkalosis - hyperinsulinism DILUTION OF SERUM POTASSIUM - water intoxication - IV therapy with potassium-poor solutions |
CARDIOVASCULAR:
- thready, weak, irregular pulse; weak peripheral pulses; orthostatic hypotension RESPIRATORY: - shallow, ineffective respirations that result from profound weakness of the skeletal muscles of respiration; diminished breath sounds NEUROMUSCULAR: - anxiety, lethargy, confusion, coma; skeletal muscle weakness, eventual flaccid paralysis; loss of tactile discrimination; parasthesias; deep tendon hyporeflexia GI: - decreased motility, hypoactive to absent bowel sounds; nausea, vomitting, constipation, abdominal distention; paralytic ileus LABS: - serum potassium levels <3.5 mEq/L ECG CHANGES: - ST Depression - Shallow, Flat, or Inverted T Wave - Prominent U Wave |
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Hyperkalemia
|
EXCESSIVE POTASSIUM INTAKE
- over ingestion of potassium-containing foods or medications, such as potassium chloride or salt substitutes - rapid infusion of potassium-containing IV fluids DECREASED POTASSIUM EXCRETION - potassium-sparring diuretics - renal failure - adrenal insufficiency (Addison's disease) MOVEMENT OF POTASSIUM FROM THE INTRACELLULAR FLUID TO THE EXTRACELLULAR FLUID - tissue damage - acidosis - hyperuricemia - hypercatabolism |
CARDIOVASCULAR:
- slow, weak, irregular HR; decreased BP RESPIRATORY: - profound weakness of the skeletal muscles leading to respiratory failure NEUROMUSCULAR: - Early: muscle twitches, cramps, parasthesias (tingling and burning followed by numbness in the hands and feet and around the mouth) - Late: profound weakness, ascending flaccid paralysis in the arms and legs (trunk, head, and respiratory muscles become affected when the serum potassium level reached a lethal level) GI: - increased motility, hyperactive bowel sounds; diarrhea LABS: - serum potassium level >5.1 mEq/L ECG CHANGES: - Tall, Peaked T Waves - Flat P Waves - Widened QRS Complex - Prolonged PR Interval |
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Serum Phosphorus
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2.7 - 4.5 mg/dL
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COMMON FOOD SOURCES:
- fish, organ meets, nuts, pork, beef, chicken, whole-grains breads and cereals |
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Hypophosphatemia
|
INSUFFICIENT PHOSPHORUS INTAKE
- malnutrition and starvation INCREASED PHOSPHORUS EXCRETION - hyperparathyroidism - malignancy - use of magnesium-based or aluminum hydroxide-based antacids INTRACELLULAR SHIFT - hyperglycemia - respiratory alkalosis |
CARDIOVASCULAR:
- decreased contractility and cardiac output; slowed peripheral pulses RESPIRATORY: - shallow respirations NEUROMUSCULAR: - weakness; decreased deep tendon reflexes; decreased bone density that can cause fractures and alterations in bone shape - rhabdomyolysis (breakdown of muscle fibers that leads to the release of muscle fiber contents (myoglobin) into the bloodstream. Myoglobin is harmful to the kidney and often causes kidney damage). CNS: - irritability; confusion; seizures HEMATOLOGICAL: - decreased platelet aggregation and increased bleeding - immunosuppression |
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Hyperphosphatemia
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- decreased renal excretion resulting from renal insufficiency
- tumor lysis syndrome increased intake of phosphorus, including dietary intake or overuse of phosphate-containing laxatives or enemas - hypoparathyroidism |
CARDIOVASCULAR:
- decreased heart rate; hypotension; diminished peripheral pulses RESPIRATORY: - not directly affected; however, respiratory failure or arrest can result from decreased respiratory movement because of muscle tetany (intermittent muscular spasms) or seizures NEUROMUSCULAR: - irritable skeletal muscles: twitches, cramps, tetany, seizures - painful muscle spasms in the calf or foot during periods of inactivity - positive Trousseau's (carpal spasm) and Chvostek's (contraction of facial muscles) signs - hyperactive deep tendon reflexes; anxiety; irritability RENAL: - urinary output varies depending on the cause GI: - increased gastric motility; hyperactive bowel sounds; cramping; diarrhea |
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Serum Sodium
|
135 -145 mEq/L
|
COMMON FOOD SOURCES:
- bacon, butter, canned food, cheese (American/cottage cheese), frankfurters, ketchup, lunch meat, milk, mustard, processed foods, snack foods, soy sauce, table salt, white and whole-wheat bread |
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Hyponatremia
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INCREASED SODIUM EXCRETION
- excessive diaphoresis - diuretics - vomitting - diarrhea - wound drainage (especially GI) - renal disease - decreased secretion of aldosterone INADEQUATE SODIUM INTAKE - NPO - low-salt diet DILUTION OF SERUM SODIUM - excessive ingestion of / irrigation with hypotonic fluids - renal failure - freshwater drowning - syndrome of inadequate ADH secretion - hyperglycemia - CHF |
CARDIOVASCULAR:
- Normovolemic - rapic pulse rate; normal BP - Hypovolemic - thready, weak, rapid pulse rate; hypotension; flat neck veins; normal or low CVP - Hypervolemic - rapid, bounding pulse; BP normal or elevated; normal or elevated CVP RESPIRATORY: - shallow, ineffective respiratory movement is a late manifestation related to skeletal muscle weakness NEUROMUSCULAR: - generalized skeletal muscle weakness that is worse in the extremeties - diminished deep tendon reflexes CNS: - headache; personality changes; confusion; seizures; coma GI: - increased motility and hyperactive bowel sounds; nausea; abdominal cramping and diarrhea RENAL: - increased urinary output INTEGUMENTARY: - dry mucous membranes LABS: - decreased urinary specific gravity - serum sodium <135 mEq/L |
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Hypernatremia
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DECREASED SODIUM EXCRETION
- corticosteroids - Cushing's syndrome - renal failure - hyperaldosteronism INCREASED SODIUM INTAKE - excessive oral sodium ingestion - excessive administration of sodium-containing IV fluids DECREASED WATER INTAKE - NPO INCREASED WATER LOSS - increased rate of metabolism - fever - hyperventilation - infection - excessive diaphoresis - watery diarrhea - diabetes insipidus (ADH related water loss) |
CARDIOVASCULAR:
- heart rate and BP responds to vascular volume status RESPIRATORY: - pulmonary edema if hypervolemia is present NEUROMUSCULAR: - Early: spontaneous muscle twitches; irregular muscle contractions - Late: skeletal muscle weakness; deep tendon reflexes diminished or absent CNS: - altered cerebral function is the most common manifestation - normovolemia or hypovolemia: agitation, confusion, seizures - hypervolemia: lethargy, stupor, coma GI: - extreme thirst RENAL: - decreased urinary output INTEGUMENTARY: - dry and flushed skin; dry and sticky tongue and mucous membranes; presence or absence of edema, depending on fluid volume changes LABS: - increased urinary specific gravity - serum sodium >145 mEq/L |
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pH
|
7.35 - 7.45
<7.35 = ACIDOSIS >7.45 = ALKALOSIS DEATH: 6.80 or < 7.80 or > |
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Pco2
|
35 - 45 mm Hg
*respiratory function indicator* |
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HCO3 (Bicarbonate)
|
22 - 27 mEq/L
*metabolic function indicator* |
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Po2
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80 - 100 mm Hg
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Respiratory Acidosis FINDINGS
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UNCOMPENSATED:
- pH: decreased - HCO3: normal - Pao2: usually decreased - Paco2: increased - K+: increased PARTIALLY COMPENSATED: - pH: decreased - HCO3: increased - Pao2: usually decreased - Paco2: increased - K+: increased COMPENSATED: - pH: normal - HCO3: increased - Pao2: usually decreased - Paco2: increased - K+: increased |
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Respiratory Acidosis S&S / CAUSES
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NEUROLOGICAL:
- drowsiness - disorientation - dizziness - headache - coma CARDIO: - decreased BP - ventricular fibrillation (related to hyperkalemia from compensation) - warm, flushed skin (related to peripheral vasodilation) NEUROMUSCULAR: - seizures RESP: - hypoventilation with hypoxia (lungs are unable to compensate when there is a respiratory problem) |
CAUSES:
- asthma - atelectasis (collapsed lung) - brain trauma - bronchiectasis (destruction and widening of the large airways) - bronchitis - CNS depressants - emphysema (COPD) - hypoventilation - pulmonary edema - pneumonia - pulmonary emboli |
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Respiratory Alkalosis FINDINGS
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UNCOMPENSATED:
- pH: increased - HCO3: normal - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: decreased - K+: decreased PARTIALLY COMPENSATED: - pH: increased - HCO3: decreased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: decreased - K+: decreased COMPENSATED: - pH: normal - HCO3: decreased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: decreased - K+: decreased |
MONITOR
- serum calcium levels - serum potassium levels ** prepare to administer calcium gluconate for tetany as prescribed** |
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Respiratory Alkalosis S&S / CAUSES
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NEUROLOGICAL:
- lethargy - lightheadedness - confusion CARDIO: - tachycardia - dysrhythmias (related to hypokalemia from compensation) GI: - nausea - vomitting - epigastric pain NEUROMUSCULAR: - tetany - numbness - tingling of extremities - hyperreflexia - seizures RESP: - hyperventilation (lungs are unable to compensate when there is a respiratory problem) |
CAUSES:
- fever - hyperventilation - hypoxia (low oxigenation) - hysteria - overventilation by mechanical ventilators - pain |
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Metabolic Acidosis FINDINGS
|
Uncompensated:
- pH: decreased - HCO3: decreased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: normal - K+: increased PARTIALLY COMPENSATED: - pH: decreased - HCO3: decreased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: decreased - K+: increased COMPENSATED: - pH: normal - HCO3: decreased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: decreased - K+: increased |
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Metabolic Acidosis S&S / CAUSES
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NEURO:
- drowsiness - confusion - headache - coma CARDIO: - decreased BP - dysrthymias (related to hyperkalemia from compensation) - warm, flushed skin (related to peripheral vasodilation) GI: - nausea, vomitting, diarrhea, abdominal pain RESP: - deep, rapid respirations (compensatory action by the lungs) |
Causes:
- diabetes mellitus or diabetic ketoacidosis (insufficient supply of insulin) - excessive ingestion of Aspirin - high-fat diet - insufficient metabolism of carbohydrates (lactic acidosis) - malnutrition - renal insufficiency or renal failure - severe diarrhea |
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Metabolic Alkalosis FINDINGS
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UNCOMPENSATED:
- pH: increased - HCO3: increased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: normal - K+: decreased PARTIALLY COMPENSATED: - pH: increased - HCO3: increased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: increased - K+: decreased COMPENSATED: - pH: normal - HCO3: increased - Pao2: usually normal (but depends on other accompanying conditions) - Paco2: increased - K+: decreased |
MONITOR
- serum calcium levels - serum potassium levels ** prepare to administer potassium chloride as prescribed** |
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Metabolic Alkalosis S&S / CAUSES
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NEUROLOGICAL:
- drowsiness - dizziness - nervousness - confusion CARDIO: - tachycardia - dysrhythmias (related to hypokalemia from compensation) GI: - anorexia - nausea - vomitting NEUROMUSCULAR: - tremors - hypertonic muscles - muscle cramps - tetany - tingling of extremities - seizures RESP: - hypoventilation (compensatory action by the lungs) |
CAUSES:
- diuretics - excessive vomitting or GI suctioning - hyperaldosteronism - ingestion of and/or infusion of excess sodium bicarbonate - massive infusion of whole blood |
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Serum Chloride
|
98 - 107 mEq/L
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Serum Bicarbonate (VENOUS)
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22 - 29 mEq/L
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aPTT
|
Normal: 20 - 36 sec
Heparin therapy: 1.5 - 2.5 x normal = 30 - 90 seconds |
- used to regulate Heparin therapy and screen for coagulation disorders
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PT
|
9.6 - 11.8 seconds (male)
9.5 - 11.3 seconds (female) *diets high in green leafy vegetables can increase the absorption of vitamin K, which shortens the PT* |
- WARFARIN SODIUM (COUMADIN) THERAPY
- screen for dysfunction of the extrinsic clotting system resulting from liver disease, vitamin K deficiency, or disseminated intravascular coagulation |
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INR (Standard Warfarin therapy)
|
2 - 3
|
INR standardizes the PT ratio
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INR (HIGH dose Warfarin therapy)
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3 - 4.5
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Platelet Count
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150,000 to 400,000 cells/mm3
|
- high altitudes, chronic cold weather, and exercise increase platelet counts
- bleeding precautions for low platelet counts |
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Erythrocyte Sedimentation Rate
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0 - 30 mm/hr
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Iron
|
Male: 65 - 175 mcg/dL
Female: 50 -170 mcg/dL |
- aids in diagnosing anemias and hemolytic disorders.
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Hemoglobin
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Male: 14 - 16.5 g/dL
Female: 12 - 15 g/dL |
- important in identifying anemias
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Hematocrit
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Male: 42 - 52%
Female: 35 - 47% |
- important measurement in identification of anemia or polycythemia
|
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RBC Count
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Male: 4.5 - 6.2 million/uL
Female: 4 - 5.5 million/uL |
- aids in diagnosing anemias and blood dyscrasias (disorders such as leukemia or hemophilia)
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Creatine Kinase (CK)
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26 - 174 units/L
|
- detects myocardial, skeletal muscle or CNS damage
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CK Isoenzymes
- CK-MB (cardiac)? - CK-MM (muscle)? - CK-BB (brain)? |
CK-MB: 0-5% of total
CK-MM: 95-100% of total CK-BB: 0% |
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Lactate Dehydrogenase
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140 - 280 units/L
*MI affects LDH1 and LDH2* **SHOULD BE REPEATED FOR 3 CONSECUTIVE DAYS** |
- the levels begin to rise about 24 hours after MI
- peaks in 48 to 72 hours - returns to normal within 7-14 days |
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Troponin I
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<0.6 ng/mL
>1.5 ng/mL indicates MI |
- increased amounts of troponins are released into the bloodstream when an infarction causes damage to the myocardium.
- levels elevate as early as 3 hours after MI - can stay elevated from 7 to 10 days after. TESTING IS REPEATED IN 12 HOURS, FOLLOWED BY DAILY TESTING FOR 3-5 DAYS |
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Troponin T
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0.1 - 0.2 ng/mL
>0.2 ng/mL indicates MI |
- increased amounts of troponins are released into the bloodstream when an infarction causes damage to the myocardium.
- levels elevate as early as 3 hours after MI - can stay elevated from 10 to 14 days after. TESTING IS REPEATED IN 12 HOURS, FOLLOWED BY DAILY TESTING FOR 3-5 DAYS |
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Myoglobin
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< 90 mcg/L
> 90 mcg/L could indicate MI |
- any injury to skeletal muscle will cause a release of myoglobin into the blood
- rises as early as 2 hours after MI - rapid decline after 7 hours *LIMITED USE IN DIAGNOSING MI* |
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ANP (Atrial Natriuretic Peptides)
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22 - 27 pg/mL
*CARDIAC ATRIAL MUSCLE* |
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BNP (Brain Natriuretic Peptides)
|
<100 pg/mL
*CARDIAC VENTRICULAR MUSCLE* |
- primary marker for identifying CHF as the cause of dyspnea
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Albumin
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3.4 - 5 g/dL
*indicative of abnormal renal function* |
Increased: dehydration, diarrhea, metastatic carcinoma
Decreased: acute infection, ascites, alcoholism. |
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Alkaline Phosphatase
|
4.5 - 13 King-Armstrong unites/dL
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- levels increase during periods of bone growth , liver disease, and bile duct obstruction.
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Ammonia
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10 - 80 mcg/dL
|
- excreted by the kidneys as UREA.
- elevated levels resulting from hepatic dysfunction may lead to encephalopathy. |
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ALT (Alanine Aminotransferase)
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4 - 6 international units/L
|
- used to identify hepatocellular disease of the liver and to monitor improvement or worsening of the disease
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AST (Aspartate Aminotransferase)
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0 - 35 units/L
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- used to evaluate a client with suspected hepatocellular disease (may also be used along with other cardiac markers to evaluate coronary artery occlusion disease)
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Amylase
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25-151 units/L
|
- enzyme, produced by the pancreas and salivary glands, aids in the digestion of complex carbs and is excreted by the kidneys.
- levels greatly increased in acute pancreatitis. - starts rising at 3 to 6 hours after the onset of pain, peaks at 24 hours, returns to normal in 2-3 days |
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Lipase
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10 - 140 units/L
|
- elevated lipase levels occur in pancreatic disorders.
- elevations may not occur until 24 to 36 hours after the onset of illness, and may remain elevated for up to 14 days |
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Bilirubin
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- Direct (conjugated): 0 - 0.3 mg/dL
- Indirect (unconjugated): 0.1 - 1 mg/dL - Bilirubin (total): <1.5 mg/dL |
- by-product of hemoglobin breakdown.
- total bilirubin levels increase with any type of jaundice - direct and indirect bilirubin levels help differentiate the cause of the jaundice. - instruct client to avoid yellow foods (carrots, yams, yellow beans, pumpkins) for 3 - 4 days - ELEVATED: ingestion of alcohol; administration of morphine sulphate, theophylline, ascorbic acid (vitamin C), or Aspirin. |
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Total Cholesterol
|
140-199 mg/dL
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LDL
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Lower than 130 mg/dL
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HDL
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30-70 mg/dL
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Triglycerides
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Lower than 200 mg/dL.
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Serum Protein
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6 - 8 g/dL
|
INCREASED: Addison's disease, autoimmune collagen disorders, chronic infection, and Crohn's disease
DECREASED: burns, cirrhosis, edema, and severe hepatic disease |
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Uric Acid
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Male: 4.5 - 8 mg/dL
Female: 2.5 - 6.2 mg/dL |
ELEVATED LEVELS COULD LEAD TO:
- gout - urate stones in the kidneys |
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Glucose Monitoring (Capillary Blood)
|
60 - 110 mg/dL
|
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Glucose (Fasting)
|
70 - 110 mg/dL
*FAST FOR 8-12 HOURS* |
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2 Hour, Postprandial Glucose Levels
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<140 mg/dL
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HbA1C
|
Good Control: 7% or Lower
Fair Control: 7 - 8% Poor Control: Higher than 8% |
- A1C is a reflection of how well blood glucose levels have been controlled for the past 3 to 4 months.
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Serum Creatinine
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0.6 - 1.3 mg/dL
(specific indicator of renal function) |
INCREASED LEVELS:
- indicate a slowing of the glomerular filtration rate |
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Blood Urea Nitrogen (BUN)
|
8 - 25 mg/dL
(specific indicator of renal function) |
INCREASED LEVELS:
- indicate a slowing of glomerular filtration rate |
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Thyroid-Stimulating Hormone (TSH)
|
0.2 - 5.4 microunits/mL
*ONLY if a thyroid disorder is suspected* |
- help differentiate primary thyroid disease from secondary causes and abnormalities
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Thyroxine (T4)
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5 - 12 mcg/dL
*ONLY if a thyroid disorder is suspected* |
- help differentiate primary thyroid disease from secondary causes and abnormalities
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Thyroxine, free (FT4)
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0.8 - 2.4 ng/dL
*ONLY if a thyroid disorder is suspected* |
- help differentiate primary thyroid disease from secondary causes and abnormalities
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Triiodothyronine (T3)
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80 - 230 ng/dL
*ONLY if a thyroid disorder is suspected* |
- help differentiate primary thyroid disease from secondary causes and abnormalities
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WBC Count
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4,500 - 11,000 cells/mm3
|
"shift to the left"
- an increased number of immature neutrophils present in the blood. "shift to the right" - found in liver disease, Down Syndrome, and megaloblastic and pernicious anemia |
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CD4+ T-cell Counts
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500 - 1600 cells/L
*monitors progression of HIV, decreases with disease progression* |
- immune system complications occur between 200 - 499 cells/L
- severe immunological complications occur with counts lower than 200 cells/L |
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Urine Specific Gravity
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1.016 - 1.022
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Digoxin (Therapeutic Serum Medication Range)
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0.5 - 2 ng/mL
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Lithium (Therapeutic Serum Medication Range)
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0.5 - 1.2 mEq/L
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